In the last decade, cancer therapy has turned toward the use of less radical forms of surgery combined with radiation, chemotherapy, and/or "preventive" therapy. An example is the treatment of breast cancer. The traditional radical mastectomy is becoming less common, replaced by removal of the breast, followed by a combination of radiation and drug treatments. During the last two decades the transplantation of bone marrow, usually from related donors, has been used following intensive, high-dose chemotherapy and drug-induced immunosuppression for the treatment of leukemia in both children and adults, and in breast and testicular cancer. Autologous transplantation (from the patient him- or herself) of bone marrow is also used.
The success of cancer treatment is usually measured by the number of surviving patients. Equally important, but more difficult to analyze, is the quality of life of such patients. Rehabilitation of the cancer patient after definitive therapy is critical for the patient's complete care. Restoration of function that had been altered by surgical, radiation, or drug treatment is most important wherever possible. When a permanent deformity or dysfunction results from therapy, rehabilitation must play a supportive role in returning the patient to self-supporting status. Finally, for those patients whose therapy has not been curative, palliative rehabilitation is important in order for the patient to maintain some degree of independence in reasonable comfort.
For most patients, rehabilitation is a continuous process after therapy. Most cancers are considered cured if the patient exhibits no recurrence within 5 years. Some tumors require 10 years or more without further clinical signs before a cure is considered definitive. Although many patients, especially those suffering from leukemia, may show a remission of all symptoms and signs of the disease following therapy, such remission may not be permanent even though it may last for several years. A relapse after remission is usually more difficult to treat than the initial occurrence.